Background: Open surgical repair (OSR) for thoracoabdominal aortic aneurysms (TAA) is associated with a high\npulmonary and renal morbidity rate. Ischemic preconditioning (IPC) is a mechanism of protection against the\ndeleterious effects of ischemia-reperfusion. To our knowledge IPC has never been tested during OSR for TAA.\nMethods: The primary objective of the study is to evaluate the efficacy of IPC during OSR for TAA with respect to\nacute kidney injury (AKI) according to KDIGO and pneumonia/prolonged ventilation-time during the first 8\npostoperative days. The secondary objectives are to compare both arms with respect to cardiac complications\nwithin 48 h, renal and pulmonary complications within 21 days and mortality at 60 days.\nTo assess the efficacy of IPC with respect to pulmonary and renal morbidity, a cox model for competing risks will\nbe used. Assuming that the event occurs among 36% of the patients when no IPC is performed, the allocation of\n55 patients to each arm should allow detecting a hazard ratio of at least 2.75 with a power of 80% when admitting\n5% for an error of first kind. This means that 110 patients, enrolled in this multicenter study, may be randomised\nwithin 36 months of the first randomization...................
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